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Prognostic value of total lesion glycolysis by 18F-FDG PET/CT in surgically resected stage IA non-small cell lung cancer

 Seong Yong Park  ;  Arthur Cho  ;  Woo Sik Yu  ;  Chang Young Lee  ;  Jin Gu Lee  ;  Dae Joon Kim  ;  Kyung Young Chung 
 JOURNAL OF NUCLEAR MEDICINE, Vol.56(1) : 45-49, 2015 
Journal Title
Issue Date
Carcinoma, Non-Small-Cell Lung/diagnosis* ; Carcinoma, Non-Small-Cell Lung/metabolism ; Carcinoma, Non-Small-Cell Lung/pathology ; Carcinoma, Non-Small-Cell Lung/surgery ; Female ; Fluorodeoxyglucose F18* ; Glycolysis* ; Humans ; Lung Neoplasms/diagnosis* ; Lung Neoplasms/metabolism ; Lung Neoplasms/pathology ; Lung Neoplasms/surgery ; Lymph Node Excision ; Male ; Middle Aged ; Multimodal Imaging* ; Neoplasm Staging ; Positron-Emission Tomography* ; Prognosis ; Recurrence ; Retrospective Studies ; Risk Factors ; Survival Analysis ; Tomography, X-Ray Computed*
PET-CT ; lung cancer surgery ; statistics ; survival analysis ; volume-dependent parameter
Despite the favorable prognosis of stage IA non-small cell lung cancer (NSCLC), the disease recurs after complete surgical resection in 20%-30% of patients. This study determined the prognostic value of various metabolic parameters of (18)F-FDG PET/CT in surgically resected stage IA NSCLC.

METHODS: We retrospectively reviewed 248 patients with stage IA NSCLC who underwent lobectomy and complete lymph node dissection after PET/CT. A region of interest was drawn on the primary lesion, and metabolic indices such as metabolic tumor volume, maximum standardized uptake value (SUV(max)), and total lesion glycolysis (TLG) were measured using an SUV cutoff of 2.5.

RESULTS: The patients included 134 men and 114 women, and the mean age was 63.03 ± 10.01 y; 129 were stage T1a (≤ 2 cm) and 119 were T1b (>2 cm). The median follow-up period was 36.6 mo. Recurrence took place in 15 patients. The mean (± SD) SUV(max), metabolic tumor volume, and TLG were 4.55 ± 3.75, 5.92 ± 5.57, and 14.42 ± 17.35, respectively. The cutoffs of SUV(max) and TLG were 3.7 and 13.76, respectively. The 5-y overall survival (OS) was 95.1% in low-SUV(max) patients and 82.2% in high-SUV(max) patients (P = 0.02). The 5-y OS was 93.7% in low-TLG patients and 78.3% in high-TLG patients (P = 0.01). On multivariate analysis, TLG was a risk factor for OS (hazard ratio, 3.159; P = 0.040), but SUV(max) showed marginal significance (P = 0.064). The concordance index of the TLG model was 0.676 (95% CI, 0.541-0.812).

CONCLUSION: TLG was a significant prognostic factor for OS in patients with stage IA NSCLC.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dae Joon(김대준)
Yu, Woo Sik(유우식)
Lee, Jin Gu(이진구)
Lee, Chang Young(이창영)
Chung, Kyung Young(정경영)
Cho, Arthur Eung Hyuck(조응혁) ORCID logo https://orcid.org/0000-0001-8670-2473
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